Acute mucus plugging is a pulmonary emergency associated with increased mortality&nbsp;and often requires rapid bronchoscopic intervention which may not be readily available in all centers. Furthermore, the role and efficacy of alternate conventional measures such as mechanical percussive therapies are uncertain. Herein, we present a patient who rapidly progressed to respiratory distress; a chest X-ray revealed left lobar atelectasis highly suggestive of acute mucus plugging. In the absence of rapid bronchoscopic intervention, bedside chest percussion was initiated with&nbsp;improvement in clinical status.&nbsp;Our case demonstrates&nbsp;the successful utilization of chest physiotherapy in the resolution of acute mucus plugging&nbsp;in an urgent situation and highlights the need for careful attention to respiratory status in high-risk patients who are also undergoing fluid removal with dialysis therapies. Copyright © 2020, Kaur et al.Non-small cell lung cancer&nbsp;is one of the leading causes of&nbsp;mortality in the United States. The BRAF mutation, which has been associated with malignant melanoma, has been documented in only 3.5-5% of the non-small cell lung cancer (NSCLC) patient population.The involvement of the&nbsp;BRAF mutation in NSCLC and the treatment for tumors with such mutations is still an evolving topic of interest, which is why more in depth information is warranted.&nbsp;We present a rare case of stage IV non-small cell lung adenocarcinoma, who presented first with a complicated pericardial effusion with evidence of malignant effusion.&nbsp;He had genetic testing done, revealing he had&nbsp;a positive BRAF V600E mutation. He was put on multiple chemotherapy regimens, but was most responsive to Vemurafenib. https://www.selleckchem.com/products/Cyclopamine.html This case will shed light into the importance of the BRAF V600E gene and its importance in NSCLC&nbsp;for better prognosis value. Copyright © 2020, Patel et al.In our empathetic understanding of abscopal effect (AbE), research has shown that the immune system is stimulated by radiation, which results in the formation of an AbE. The AbE is referred to as a response from the irradiated volume. Despite the existence of key gaps in our understanding, there is an urgent need to explore what the underlying effect is. The aim of this article is to argue&nbsp;neurosurgeons and the healthcare practitioner's knowledge of the AbE. Our goal is to identify more gaps in our understanding of the AbE and seal other gaps as well. This study will review medical journals and bring together the most updated information related to AbEs. Copyright © 2020, Adjepong et al.Background In July 2014, the Institute of Medicine released a review of the governance of Graduate Medical Education (GME), concluding that changes to GME financing were needed to reward desired performance and to reshape the workforce to meet the nation's needs.&nbsp;In light of the rapid emergence of alternative payment systems, we evaluated the financial value of resident participation in operative surgical care.&nbsp; Methods The Department of Surgery provided Current Procedural Terminology (CPT) codes for procedures performed by the general surgical service at our institution for the 2011 academic year. For each code, the charge and total instances were provided. CPTs allowing an assistant fee were identified using the Searchable Medicare Physician Fee Schedule. This approach enabled calculation of the potential resident contribution to GME funding. Results A total of 515 unique CPTs were potentially billable for a total of 6,578 procedures, of which 2,552 (39%) were reimbursable.&nbsp;These CPTs would have generated $1,882,854 in assistant charges.&nbsp;The top 50 most frequent CPTs resulted in 4,247 procedures.&nbsp;Within the top 50, 1362 procedures (32% of the top 50, 21% of the total) were reimbursable.&nbsp;Of the total assistant charges, $963,227 (51%) occurred in the top 50 most frequent CPTs. Conclusions Credit for resident participation in operative care as co-surgeon would average $67,244 per resident, compared to our current funding of $142,635 per resident. This type of alternative funding could provide 47% of current educational support.&nbsp;The skew in distribution of procedures also suggests that such a system could provide guidance to a more balanced operative experience.&nbsp;Such performance-based credentialing could be used to ensure appropriate housestaff for a given case; these reimbursements could also be adjusted based on quality metrics to provide for transformational change in patient outcomes. Copyright © 2020, Dimon et al.Objective Post-dural puncture headache (PDPH) after an accidental dural puncture is a very common complication of epidural analgesia/anesthesia. We observed the ability of a triple prophylactic method (epidural saline, morphine, and intravenous (IV) cosyntropin) to prevent PDPH and the need for a blood patch.&nbsp; Methods We retrospectively evaluated the effect of the combination of epidural saline, IV cosyntropin, and epidural morphine in parturients who had an accidental dural puncture with regard to the PDPH rate and the need for an epidural blood patch. We report a case series of patients with accidental dural puncture who underwent triple prophylaxis and other methods. Results Thirty-one patients were included in the study. Fourteen cases received triple prophylaxis (45%). Three patients in this group developed PDPH (21%), with two of them requiring a blood patch (14%). Nine patients underwent preventive measures other than triple prophylaxis&nbsp;with a PDPH rate of 55% and one needing a blood patch (11%). Conservative management was used in eight patients&nbsp;with PDPH and blood patch rates of 100% and 62%, respectively. Conclusion The triple prophylactic regimen of epidural saline, IV cosyntropin, and epidural morphine used after accidental dural puncture exhibits great potential to reduce the incidence of PDPH and the need for blood patch in obstetric patients. Copyright © 2020, Riveros Perez et al.Liver abscesses are divided into two main subgroups pyogenic and nonpyogenic abscesses. Early diagnosis is important for appropriate treatment and to reduce the morbidity and mortality rates in liver abscesses. We report a case of multiple pyogenic liver abscesses mimicking liver metastases on multidetector computed tomography (MDCT). The case is unique as it shows a rare presentation of pyogenic liver abscess that cannot be distinguished from metastatic liver disease. Microbiologic and pathologic correlations with follow-up may be necessary for these patients. The case is presented with an emphasis on the MDCT findings. Copyright © 2020, Özgül et al.